Contraceptives for Your Teenage Daughter: A Path to Safety or a Step Too Far?

A story from a Nigerian secondary school recently stopped me in my tracks. A teacher disciplined an SS2 girl, noticed blood on her arm, and discovered a contraceptive implant. When the school investigated, they found 40 other girls, all around 15 or 16, with the same device. As a public health nurse who worked for years in a private hospital in Lagos, I’ve seen what happens when teens navigate sexual health alone. I understand the cultural and moral values that shape our communities—values that emphasize abstinence and family honor. But this story is a call to action for African parents and nurses. If we don’t get involved, our daughters will find ways around us, often turning to untrained providers with dangerous consequences. Let’s talk openly, without stigma, drawing from my experiences in Lagos, insights from Europe, and practical steps to guide our teens while respecting our values.

The School Story: A Signal of Change

Imagine a Nigerian classroom: students in neat uniforms, a teacher keeping order. A 16-year-old girl gets in trouble, and blood drips from her arm. It’s not a cut—it’s a contraceptive implant, designed to prevent pregnancy for three years. The school digs deeper and finds 40 girls with these implants. That’s 40 teenagers making adult choices without their parents’ knowledge. It raises hard questions: How are they accessing these devices? Who’s providing them? And why don’t they feel they can talk to us?

I understand the cultural and moral values that make this story unsettling. In Nigeria, and across Africa, our traditions, Christian and Muslim faiths, and community norms teach that sex belongs in marriage. These values are the foundation of our families, guiding us to raise daughters with discipline and respect. But the reality is, some teens are sexually active. About 20% of girls aged 15–19 in sub-Saharan Africa have been pregnant, often unplanned (Guttmacher Institute, 2021). Contraceptive implants are 99% effective at preventing pregnancy, but when teens get them in secret, it shows we’re not bridging the gap between our values and their realities. If we don’t step in, they’ll turn to untrained hands, risking their health.

From Lagos: The Cost of Silence

In my five years at a private hospital in Lagos, I saw the consequences of leaving teens to fend for themselves. One night, a 15-year-old, let’s call her Tolu, arrived in the gynecology ward, pale and bleeding heavily from an abortion done by an untrained provider. She was too scared to tell her parents she was pregnant, fearing their disappointment, so she went to a backstreet clinic. We stabilized her, but the infection she developed could affect her fertility for years. Another girl, 17, came in with severe pain and a fever after a botched procedure. Her parents, devout and traditional, had no idea she was sexually active until she was rushed to us.

These aren’t isolated cases. Nigeria sees about 1.2 million abortions annually, with teens making up a large share (WHO, 2020). Complications—bleeding, infections, sometimes death—are common. Many teens turn to unqualified providers because they fear stigma from parents or healthcare workers. The girls in the school story were likely trying to avoid Tolu’s fate, but doing it in secret meant no one ensured their safety. Our cultural emphasis on abstinence is vital, but when teens don’t follow that path, silence pushes them toward danger.

Europe: A Model to Consider

Europe offers a perspective worth studying. In countries like the Netherlands and the UK, teen pregnancy rates are low—about 5 per 1,000 girls aged 15–19, compared to 100–200 per 1,000 in parts of Africa (UNFPA, 2020). They start sex education early, around age 11, teaching kids about relationships, consent, and contraception. Teens can access free condoms, pills, or implants at clinics without judgment, as long as they understand their choices. A 2019 study found 80% of sexually active UK teens use contraception consistently (Journal of Adolescent Health, 2019). Parents are encouraged to join these conversations, not stay on the sidelines.

Europe isn’t perfect—some teens face STIs or pressure to be sexually active too soon. But their openness reduces harm. I read about a Dutch parent who gave her 15-year-old son a pack of condoms, not to encourage sex, but to ensure safety if it happened. In Africa, our cultural and moral values make such actions feel like a step too far for many. Yet, we can find a middle ground—honoring our beliefs while preparing our daughters for the world they’re navigating.

Why This Matters

The school story is about more than implants—it’s about our daughters making choices without us. Unplanned pregnancies disrupt lives: 20% of African girls aged 15–19 drop out of school due to pregnancy (UNESCO, 2021). Unsafe abortions, often from untrained providers, are a leading cause of death for young girls. In my hospital, I saw girls survive but carry scars—physical, like infertility, and emotional, like shame. Contraceptives, used responsibly, can prevent this. Implants are safe, reversible, and don’t cause infertility, despite myths. But when teens access them without guidance—or worse, from untrained providers—it’s a sign we’re failing them.

Nurses and Healthcare Professionals: Guiding with Care

Nurses and healthcare providers are on the front lines, and their approach can shape outcomes. In Lagos, I worked with colleagues who saw teens daily, and we learned what helps and what doesn’t.

What Nurses Should Do:

• Offer Youth-Friendly Spaces: Teens need clinics where they can ask questions without fear. In Kenya, programs like the Adolescent Reproductive Health Project train nurses to provide nonjudgmental care. Nigeria needs more of these spaces where teens feel heard, not shamed.
• Educate Families Together: In Lagos, some nurses held sessions with parents and teens, explaining options like implants or condoms. This respects cultural values while clarifying myths, like fears that contraceptives harm fertility.
• Advocate for Clear Policies: Nurses should push for guidelines balancing teen confidentiality with parental involvement. Europe’s “mature minor” rule, where teens can consent if they understand the decision, could guide Africa’s approach.
• Debunk Myths: Nurses can use every visit to share facts, like how implants are reversible (WHO, 2020), helping teens and parents make informed choices.
• Work with Schools: Nurses can deliver health talks in schools, like Nigeria’s Family Life and HIV Education curriculum, ensuring teens get accurate information early.

What Nurses Should Avoid:

• Stigmatizing Teens: I’ve seen nurses lecture teens about “morality” instead of listening. This drives kids to untrained providers, like in Tolu’s case, with devastating results.
• Ignoring Parents: Providing implants to minors without parental knowledge, as likely happened in the school story, erodes trust. Nurses must strive for transparency where possible, respecting cultural expectations.
• Skipping Follow-Up: Contraceptives like implants need monitoring for side effects. Nurses who don’t follow up risk complications, especially for teens who may not report issues.
• Relying Solely on Abstinence: Promoting abstinence aligns with our values, but dismissing contraception discussions ignores reality. Nurses must prepare teens for safe choices.

What Parents Can Do: Steps Without Stigma

As a parent and nurse, I know these conversations are tough, especially when our cultural and moral values prioritize purity and family honor. But if we don’t engage, our daughters will find ways around us—often with risky outcomes. Here’s what I’ve seen work:

• Start Small, Stay Open: Bring up the school story casually: “I heard about girls in a school using implants—what do kids your age think about that?” Listen first. It’s uncomfortable, but it builds trust.
• Get the Facts: Many parents fear contraceptives defy our values or cause harm. They don’t. In Lagos, I reassured parents that implants are safe and removable. Resources from Fellow Nurses Africa or your local clinic can clarify this.
• Watch with Warmth: Know your daughter’s friends, her online world, her school life. But don’t make her feel like a suspect. Tolu’s mom wished she’d asked questions with kindness, not control.
• Partner with Schools: The school in the story missed warning signs. Push for health education programs in your daughter’s school. Some Nigerian schools teach life skills—ensure yours does.
• Demand Safe Care: If your daughter needs contraception, it should come from a clinic that explains everything and involves you when possible. In Lagos, I saw nurses bridge this gap by talking to families together.

Moving Forward: Balancing Values and Reality

The school story shows our daughters are acting, whether we’re ready or not. Our cultural and moral values—rooted in faith and community—are precious, guiding us to raise daughters with integrity. But if we stigmatize them for seeking protection, they’ll turn to untrained providers, risking their lives. We don’t need to copy Europe, but we can borrow their openness: clear education, accessible care, and parents in the conversation. Some families may choose early marriage, rooted in tradition. Others may see contraception as a practical way to safeguard their daughters. Either way, it’s about guiding without judgment.

At Fellow Nurses Africa, we’re here to help. Share your story—your concerns, your successes, or your questions. Join our community for workshops, resources, and tips on talking to your daughter. Those 40 girls weren’t rebelling—they were trying to protect themselves, but they needed us. Let’s show up for our daughters, as parents and nurses, with wisdom and care.

When we guide without stigma, our daughters thrive.

Fellow Nurses Africa is the independent voice of African nursing, we educate, inform and support the nursing profession.